Give Yourself A Gift This Year - Stay Healthy During The Holidays

Dr. Enrique Jacome

It’s that time of year again. It’s hard to believe another year has flown by. Christmas songs are on the radio, shops are displaying their Christmas themed windows, and my inbox is full of Christmas wishes. With the risk of sounding a little like the Scroodge, please be sensible this holiday. It’s not called the silly season for no reason. With all the partying, drinking, indulging, overeating and running around like a headless chicken from event-to-event and shop-to-shop, it’s no wonder many of us feel tired, rundown, overweight and stressed as the new year comes around.

What if this year you honored YOU and entered the new year feeling refreshed, energized, slim and relaxed? It’s really not so difficult. Just a little discipline and willpower, that’s all.

Top 5 Tips to help you stay healthy over the holidays:

1. Exercise
Remember to keep up with your exercise routine. Just because you were out and about the night before is no excuse to sleep in and forego your workout. Staying active will help you feel better. I promise! Try and exercise outside as much as possible and take advantage of the bright sunny summer days. If a run is too much, how about calling a friend and take a brisk walk around the park.

2. Relaxation
As much as Christmas is a lovely time to catch up with all your friends and family, remember to take some time out for YOU. Take a few moments in the day to practice meditation or stress-relieving breathing techniques. We’re conditioned to think that Christmas is all about giving, so how about taking the time to give to yourself as well this year. Don’t get stressed out over Christmas present buying. Plan your shopping in advance, write a list of all the presents you need to buy and avoid the frenzied crowds.

3. Nutrition
Remember to make healthy choices this Christmas. It’s easy to get carried away with all the puddings and chocolates and shortbread and party food, but before over-indulging remember how it’s going to make you feel the next day. Remember to eat plenty of vegetables, fruits and whole grains. If you do like enjoying Christmas treats, limit your portion size.

4. Water
Drink plenty of water to keep you hydrated. If you do drink alcohol, remember to alternate every alcoholic drink with a glass of water and please don’t drink on an empty stomach. Best to have a healthy snack before you go to the party as it will also prevent you from snacking on unhealthy party food. Dandelion tea is a great herbal tea to drink throughout the days when you know you’re going to be drinking alcohol, as it helps to detoxify the liver.

5. Sleep
Get plenty of rest and aim for 7-8 hours of sleep every night. It’s not going to make or break your life if you don’t go to EVERY holiday party. How about having a night in? Create a relaxing spa experience at home, snuggle up on the couch with a good book or DVD and get to bed early.

And if all that fails, please don’t beat yourself up about it. Take each day as it comes and strive for a healthier day the next day during the holiday season!

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New Genetic Test Detects Early Breast Cancer And Identifies Future Risk

Dr. Enrique Jacome

Physicians may now be better at detecting breast cancer than ever before, but much more work remains to ensure accurate diagnosis is possible and especially to assess future risk. That's why researchers from Germany have been working to develop a new test of gene action to predict cancer risk both at first diagnosis and into the future. In a new research report appearing in the December 2012 issue of The FASEB Journal, researchers show that the various genetic switches, which are turned on and off in the regular development of every cell in the body, can be analyzed in minute detail to determine the presence or risk of breast cancer growth.

"We hope that our results help to develop tools to identify breast cancer patients when tumors are still small, and eventually curable," said Clarissa Gerhauser, Ph.D., a researcher involved in the work from the Division of Epigenomics and Cancer Risk Factors at the German Cancer Research Center in Heidelberg, Germany. "These tools might hopefully also help to predict the progression of tumor development and guide decisions on cancer treatment."

To make this advance, Gerhauser and colleagues extracted DNA from 10 small tumor tissue samples and 10 normal breast tissues from breast cancer patients. They made small fragments from the extracted DNA and identified the genetic switches within those fragments. By comparing the results from various combinations of DNA fragments, scientists discovered which switches were more prevalent in tumor tissue than in normal breast tissue. The methods used to quantify the switches are extremely sensitive, making it feasible that small biopsies would be sufficient for analysis and testing.

"This is a milestone. The method described detects activity at the genetic level, which often occurs well before any outward symptoms occur," said Gerald Weissmann, M.D., Editor-in-Chief of The FASEB Journal. "Not only could this allow for earlier diagnosis of breast cancer and more accurate risk assessment, but eventually, this technique might be used in other types of cancer as well."

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Warning: Online Information About Designer Vagina Procedures Can Be Misleading And Inaccurate

Dr. Enrique Jacome

Internet information regarding "designer vagina" procedures for women is often poor and sometimes inaccurate, suggests a new report published in the Obstetrics & Gynecology edition of the journal BMJ Open.

The findings encourage researchers to urge that guidelines be created to improve criteria in order for women to make educated choices about an increasingly growing trend that has hardly been investigated as of yet.

Previous research states that in recent years, vaginal cosmetic surgery as become more popular, with little to no clinical or scientific evidence to help guide surgeons on how to perform safe procedures.

Cosmetic procedures are now readily available to women who don't particularly like the way their genitals look. These surgeries include "G-spot amplification" and "vaginal rejuvenation", as well as modifying the shape of the external lips of the vagina.

The researchers used Google to identify private providers offering female genital cosmetic surgery and wrote about the first five US and UK websites that showed up in the search results. The content of the information offered by these websites was examined using sixteen different criteria starting from what, and how these surgeries are performed, to possible risks, and success rates.

Language was also examined, including the use of phrases such as "labial hypertrophy", suggesting that the procedure is used as treatment for a medical issue. The authors say that the lack of standard terminology on these websites makes it difficult to interpret exactly how many procedures are being offered. There are around 72 procedures referred to on 10 separate sites with terms like "labioplasty", "liposculpting", "hoodectomy", and "hymenoplasty".

On all the sites, concern about the appearance of genitals were touched upon, as well as the visibility of vaginal labia through tight clothing, and consciousness of larger than normal labia. Many sites endorsed labial reduction for a "youthful vulval appearance." One website even described this as: "a woman might have a face lift and look really young until she goes to bed and a partner can see the evidence of aging there."

Procedures were often suggested to make the labia "more appealing" or "sleeker." Even though natural variation of labia shape and size was referenced, three sites still recommended surgery. All sites said it would improve vulval appearance.

Hymen intactness, which indicates virginity, can be achieved by hymen repair surgery and was often recommended for improving "the woman's hidden aesthetics". They claimed this would ensure a woman would be "pure" on her wedding night.

Three websites said that labial surgery can improve personal hygiene and eliminate the risk of infections, which investigators say may strengthen negative emotions towards the vagina, known as "pudendal disgust."

Nearly half of the websites suggested that surgery would enhance sexual pleasure.

Just two websites demonstrated success rates of 95 or 100 percent, but what was measured as success was not clearly specified. Restored confidence and self-esteem were also mentioned as part of unproven psychological and social advantages mentioned by all websites.

Every site touched upon risks, but they were made to appear less important than they actually were; four sites did not say what the risks were; and just one gave information on revision rates. Three websites mentioned "botched" surgeries that might cause disfigurement and need correction done by other providers.

None of the websites suggested a minimum age limit for surgery, which the researchers found quite troublesome, because the human anatomy changes throughout a woman's lifespan.

The authors realize that this study just offers a small picture of the information available at a single point in time. But they do recognize this is the first time this subject has been methodically examined. 
The researchers conclude that designer vagina surgeries take advantage of women's fears and that any uneasiness they might have could be better addressed by psychological therapy, creams, or moisturizers rather than surgical procedures.

This report highlights significant gaps in the breadth, depth, accuracy and quality of clinical information given by some service providers of female genital cosmetic surgery...and highlights a certain degree of distortion to the information provided by medical practitioners in an area that is imbued with value judgement.

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Tips For A Healthy & Happy Thanksgiving

Dr. Enrique Jacome

Thanksgiving is one of the best holidays of the year. There is no better excuse to express gratitude for those that you love the most and open your heart and your home to spread the love.  Although some people look forward to, literally, pigging out all day, there is a better and healthier way to enjoy Thanksgiving without the proverbial hangover that comes from overindulging (whether that be food, alcohol, or both). Here are five tips to make the most out of this wonderful holiday:

1. Be sure to eat a healthy and hearty breakfast. Don’t be fooled into thinking that by skipping out on breakfast you have license to eat that much more during the Thanksgiving feast. It’s never fun to feel overstuffed. Eating a healthy breakfast that includes lean protein (eggs or egg whites, salmon, protein-enhanced smoothie, Greek yogurt) and fresh fruit (apples, pears, berries) or vegetables (spinach, bell peppers, broccoli) will get the day started on the right track and help keep you satisfied and less likely to binge or “pick” throughout the day. Take it from a seasoned Thanksgiving cook, there’s nothing quite as annoying as the person who is constantly in the kitchen picking at all the food one is meticulously putting out on serving trays.

2. Get some vigorous exercise first thing in the morning. Get outdoors for a hike, brisk walk, bike ride or run. The outdoors is invigorating and you’ll take in some needed vitamin D. You’ll also set your metabolism in gear as you prepare to potentially take in a few more calories than normal.

3. Start small. If offered, always choose the smaller plate size. We are less likely to overindulge when we use smaller plates. Why? Smaller plates equals smaller portions. Go generous on the vegetables. Say yes to soup.

4. Take your time. Although it is tempting to dive right in and (pardon the pun) gobble everything down so you can be first at seconds, taking the time to chew, breathe, and put the fork and knife down between bites will actually result in less chance of overeating. It takes the brain a little bit of time to register satiety (the feeling of fullness) after the food hits the stomach and gastrointestinal tract. When you plow through your food without taking time to pause, you’ll likely be that person who ends up having to loosen that top button on his pants or leaning way back in your chair because your trying to create space for your diaphragm to expand and contract.

5. Make the best choices. There are some stellar superfoods available this time of year and they often show up on the Thanksgiving table. Sweet potatoes are fabulous on their own – they don’t need extra butter and sugar. As a superfood, they are loaded with carotenoids, fiber, antioxidants and vitamins. So definitely say yes to sweet potatoes. Cranberries are also a definite yes. Say no to ham, which is usually loaded with sodium and nitrites but yes to turkey breast. Limit the amount of gravy you use, especially if it has been prepared with excess fat drippings or tons of butter. Pescatarians (vegetarians who also eat fish) may chose poached salmon for their main dish. Vegans may chose Tofurkey, a tofu-based dish with imitation turkey flavor. Say yes to winter green salad made with spinach, beats, pears and slivered almonds. I suggest skipping the stuffing altogether (you have enough starch from the sweet potatoes). Try alternatives to stuffing, such as wild rice or quinoa pilaf. For dessert, say yes to pumpkin pie but pass on the pecan pie. Although we love pecans, pecan pie is typically loaded with excess fat and sugar.

More than anything this Thanksgiving, be grateful for the table set before you! Give thanks for all who came together to make the feast possible. And if you’re looking for extra credit or at least a good excuse to burn a few extra calories, put on some great music after your meal and dance the Thanksgiving night away.

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A Healthy & Yummy Halloween Treat

“Halloween” or “All Hallow’s Eve” dates back 2,000 years to the most significant Celtic holiday: the night before the new year (November 1 on their calendar), when the dead returned to mingle with the living. Scary faces were sculpted into turnips and gourds and lit with burning embers to ward off evil spirits. Today’s jack-o-lanterns are but one vestige of that pagan celebration. However, pumpkins have other uses besides keeping evil spirits away and frightening trick-or-treaters. 

This Halloween, do the neighborhood ghosts and goblins—and yourself—a favor. Try my favorite Halloween recipe instead of munching on all that unhealthy candy.

Low-Fat Pumpkin Banana Bread

Ingredients
•    1 mashed, ripe banana
•    1 cup pumpkin puree
•    1/4 cup coconut oil
•    1 large egg
•    2 egg whites
•    2 cups whole wheat flour
•    1 tsp baking powder
•    1/2 tsp baking soda
•    1/2 tsp salt
•    2/3 cup sugar
•    1/2 tsp nutmeg
•    1/2 tsp ginger
•    1 tsp cinnamon

Preparation
Preheat oven to 350 degrees. Spray a 8 1/2 X 4 1/2-inch loaf pan with nonstick cooking spray.

Place mashed banana, pumpkin puree, oil, egg and egg whites in a large bowl. Beat with an electronic mixer on low speed.

Place flour, sugar, baking powder, baking soda, salt, nutmeg, ginger and cinnamon in a medium bowl and stir with a whisk. Add flour mixture to banana and pumpkin mixture and beat until just moist.
Pour batter into loaf pan and bake for 1 hour or until toothpick placed in center comes out clean. It serves twelve.

An occasional sugar splurge isn't going to hurt you, but overindulgence can contribute to a host of health problems. So this Halloween try replacing those unhealthy treats with tasty ones like this.

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A New Recommendation For Pap Smear Testing Has Been Released, But This Does Not Mean You Can Skip Your Annual Exam

Dr. Bev Blessing FNP, PHD

A new recommendation for pap smear testing has been released with the opening line of "most women need testing for cervical cancer only every three to five years". For many readers that statement can sound like most women can begin to skip their annual exams. What the article does not say is probably more important than what it does say.  

The new recommendation is only focusing on screening for cervical cancer in low risk populations. It does not address high risk patients, people with compromised immune systems, those with increased risk factors, changes related to STDs, or many other gynecologic areas of concern. It also does not mention screening for vulva cancer, vaginal cancer, uterine cancer, ovarian cancer or breast cancer, which are routinely a part of the annual exam.  The recommendation is only referring to pap smears. 

What that means for most of us, is that at our annual women's health exam, during the pelvic portion, a sampling of the cervical fluid will not be tested except every 2-3 years. Everything else stays the same. The bottom line is: To ensure your health as a woman, it is still very important keep your appointment for your annual exam!

Read the recommendation here: http://bit.ly/V1ptIA

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Study Shows That Maternal-Newborn Separation When Both Mother And Newborn Admitted To ICU Following Birth Increases Risk Of Death Significantly

Dr. Enrique Jacome

Mothers and newborns who are both admitted to an intensive care unit (ICU) after delivery are significantly more likely to die compared with mom-baby pairs not needing ICU admission, found a study in CMAJ (Canadian Medical Association Journal). As well, when both mother and baby require admission to an ICU, they are much more likely to be managed at different hospitals, thereby negatively impacting maternal-infant bonding. 

Researchers completed a population-based study of all 1.02 million live born singleton deliveries in Ontario between 2002 and 2010. They found that infant mortality was 28 times higher and maternal death 330 times higher when a newborn was admitted to a neonatal ICU (NICU) while its mother was admitted to an adult ICU - collectively called "co-ICU" - than when neither mom nor baby was admitted to an ICU. Separation of mother and infant soon after birth was 31 times more common with co-ICU than no ICU, because one or both needed to be transferred to another hospital. 

"In addition to being at high risk of death, newborns admitted to the NICU experience long-term morbidity," writes lead author Dr. Joel Ray, Departments of Medicine, and Obstetrics and Gynaecology, St. Michael's Hospital, and the Institute for Clinical Evaluative Sciences. "This produces a great deal of stress for the parents." When the mother requires admission to an ICU as well, she may be unable to care for, or bond with, her baby. This can have long-term implications for mother-child bonding. 

To explain the higher risk of death for mothers and babies both admitted to an ICU, the authors suggest that "abnormalities of the maternal and fetal placental circulations may often co-exist, and a diseased placenta may adversely affect mother and fetus alike. Placental dysfunction may result in preeclampsia, placental abruption and placental infarction, paralleled by an increased rate of preterm cesarean delivery and involvement of the maternal hepatic, cardiac, renal and cerebral systems." 

Coordination of care plans by ICU staff for mothers and babies in their respective ICUs, especially by trained social workers, as well as efforts to transfer mothers and babies to the same hospital, may help lessen the burden of maternal-newborn separation. 

The authors conclude that "co-ICU admission may be one optimal marker of maternal and infant morbidity and mortality beyond maternal ICU or NICU admission alone."

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Study Shows That Language Development In Babies Affected By Maternal Depression

Dr. Enrique Jacome 

Maternal depression and a common class of antidepressants can alter a crucial period of language development in babies, according to a new study by researchers at the University of British Columbia, Harvard University and the Child & Family Research Institute (CFRI) at BC Children's Hospital. 

Published in the Proceedings of the National Academy of Sciences, the study finds that treatment of maternal depression with serotonin reuptake inhibitors (SRIs) can accelerate babies' ability to attune to the sounds and sights of their native language, while maternal depression untreated by SRIs may prolong the period of tuning. 

"This study is among the first to show how maternal depression and its treatment can change the timing of language development in babies," says Prof. Janet Werker of UBC's Dept. of Psychology, the study's senior author. "At this point, we do not know if accelerating or delaying these milestones in development has lasting consequences on later language acquisition, or if alternate developmental pathways exist. We aim to explore these and other important questions in future studies." 

The study followed three groups of mothers - one being treated for depression with SRIs, one with depression not taking antidepressants and one with no symptoms of depression. By measuring changes in heart rate and eye movement to sounds and video images of native and non-native languages, the researchers calculated the language development of babies at three intervals, including six and 10 months of age. Researchers also studied how the heart rates of unborn babies responded to languages at the age of 36 weeks in the uterus. 

"The findings highlight the importance of environmental factors on infant development and put us in a better position to support not only optimal language development in children but also maternal well-being," says Werker, who adds that treatment of maternal depression is crucial. "We also hope to explore more classes of antidepressants to determine if they have similar or different impacts on early childhood development." 

Background 

"These findings once again remind us that poor mental health during pregnancy is a major public health issue for mothers and their infants," says co-author Dr. Tim Oberlander, a professor of developmental pediatrics at UBC and CFRI. "Non-treatment is never an option. While some infants might be at risk, others may benefit from mother's treatment with an antidepressant during their pregnancy. At this stage we are just not sure why some but not all infants are affected in the same way. It is really important that pregnant women discuss all treatment options with their physicians or midwives." 

Previous research by Werker has found that during the first months of life, babies rapidly attune to the language sounds they hear and the sights they see (movements in the face that accompany talking) of their native languages. After this foundational period of language recognition, babies begin focusing on acquiring their native tongues and effectively ignore other languages. 

The current study suggests that this key developmental period - which typically ends between the ages of eight and nine months - can be accelerated or delayed, in some cases by several months. In another recent study, Werker has found that this development period lasts longer for babies in bilingual households than in monolingual babies, particularly for the face recognition aspects of speech. 

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UK Study Shows That Everyday Chemicals Raise Country's Breast Cancer Rates

Dr. Enrique Jacome

Ever since they have routinely added synthetic chemicals to everyday household and personal care products, the breast cancer rate among women in the UK has risen dramatically, says Breast Cancer UK, a British charity.

According to the UK office for National Statistics, in 1971 out of 100,000 women, only 66 got breast cancer, in 2010 the figure jumped to 126 per 100,000 - an increase of nearly 100%. However, since screening was introduced in 1987, the number of women dying from the disease has been falling steadily.

Women are exposed to toxic chemicals every time they put on makeup, clean the house or use plastic. A growing number of scientists believe that routine exposure to such chemicals may be having an impact on breast cancer rates.

Breast Cancer UK predicts that 1 in every 8 women will develop breast cancer at some time in their lives. This increase in breast cancer rates is expected to continue rising.

The authors of a new report from Breast Cancer UK say that it is possible to reduce chemical exposure by taking some simple steps. Many things that people come into contact with every day have chemicals we do not know very much about, especially what long-term exposure might cause. Examples of products include the lining of bottles and food cans, plastic lunch boxes, personal care products, cosmetics, and cleaners. According to Breast Cancer UK, many of these products do contain chemicals that raise the risk of developing breast cancer.

The charity says that the chemicals in these products typically end up inside a woman's body. On a daily basis, people may be rubbing hormone-distributors which make their way into the body through their skin. We are also eating and drinking these chemicals.

Here are some steps you can take to reduce your exposure to breast cancer causing chemicals:

Shop for safer products - products today list which chemicals are included in their manufacture or preparation. Look for goods that have a certified label for organic ingredients. Labels with few ingredients tend to have products which are less toxic. Also, when using these products, do so less often and in smaller amounts.

Be extra careful with food and drink - if you are drinking or eating chemical-laden products, you are much more likely to have an accumulation of hazardous chemicals in your body. Be especially careful with babies and young children, they cannot eliminate these compounds from their system as well as adults can, especially BPA and other hormone disrupting substances. Researchers from Yale University School of Medicine in New Haven, Conn. revealed in Hormones & Cancer in 2010, in a study in mice that prenatal exposure to endocrine-disrupting chemicals can raise a female's risk of cancer later on in life. Examples of hormone-altering substances include bisphenol-A (BPA) and diethylstilbestrol (DES)


Cut down on consuming or using the following products:

• Foods and drinks that come in cans. Look out for cans that say they are BPA free on the label. The majority of cans contain Bisphenol A (BPA). A chemical that upsets our hormone system - BPA has been associated with breast cancer risk.


• Products with fragrance added, such as cleaning products, washing powder (detergent) and air fresheners. In order to make them unpalatable (undrinkable), manufacturers commonly add PVC.


• Body care products - avoid, or cut down on the ones that contain TEA (triethanolamine), Formaldehyde, DEA (diethanolamine), Parabens, Sodium Lauryl/Laureth Sulfate, Phthalates (DEHP, BBP, DBP, DMP, DEP), DMDM Hydantoin, Triclosan, Fragrance, PEGs (polyethylene glycol), and anything with "glycol" or "methyl.


• Hand washes and anti-bacterial soaps - look for products without Triclosan, which can disrupt hormones and has been associated with breast cancer risk


• Toothpaste - avoid those that contain Triclosan. If you really want to go back to basics, brush your teeth with baking soda.


• Products with Parabens - some drinks, pie fillings, beers, pickles and jams may contain Parabens. Parabens may disrupt the hormones. Cosmetic product labels will list them if they have been added, however food products might not. Seek out Parabens-free goods. Scientists from the University of Reading, England, found traces of Parabens in all the tumor samples taken from women with breast cancer. They added that further studies are needed to find out why.

You can make your make your own cleaning products:

• Window cleaner - mix three tablespoons of vinegar with 1 quart of water in a spray bottle. Some people say the vinegar-water mix should be 50-50. If the windows are very dirty, use ½ teaspoon of liquid soap, 3 tablespoons of vinegar and 2 cups of water. Shake it all up. Wipe the glass afterwards with newspaper rather than paper toweling them.


• All purpose disinfectant - mix 2 teaspoons of borax, 4 tablespoons of vinegar and 3 to 4 cups of hot water into a spray bottle. If you want it to be extra powerful, add ¼ teaspoon of liquid soap.


• General dusting - use a damp cloth. You could add 1 teaspoon of olive oil per ½ cup of vinegar, mix it all together in a bowl and use it to wet a small cloth.

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New Breakthrough For In Vitro Fertilization

Dr. Enrique Jacome

Researchers at the University of Gothenburg have discovered that a chemical can trigger the maturation of small eggs to healthy, mature eggs, a process that could give more women the chance of successful IVF treatment in the future. The results have been published in the journalPloS ONE. 

Women and girls treated for cancer with radiotherapy and chemotherapy are often unable to have children as their eggs die as a result of the treatment. 

Although it is now possible to freeze eggs and even embryos, this is not an option for girls who have yet to reach puberty. A better way of preserving their fertility is to freeze slices of ovarian tissue that contain small immature eggs, and subsequently mature these eggs so that they can be used in IVF treatment. Unfortunately there is, at present, no way of maturing small eggs in an artificial environment outside the body. 

A research group led by professor Kui Liu at the University of Gothenburg has recently discovered that a chemical which inhibits the PTEN molecule can trigger the maturation of small eggs to form healthy, mature eggs. 

Carrying out a study on mice, the researchers managed to produce five live young mice from eggs matured using this PTEN inhibitor to help the growth and maturation process. 

The results have been published in PloS ONE and build on previous results published in Science, where the group showed that PTEN is a molecule that inhibits an egg's development. 

"This discovery demonstrates that there is a realistic chance of being able to use PTEN inhibitors to activate small eggs in a test tube," says Kui Liu, professor at the University of Gothenburg's Department of Chemistry and Molecular Biology. 

Professor Kui Liu has led the study and is optimistic about the new method. "This technique is extremely valuable for those women who have only small eggs in their ovaries and cannot be helped by IVF as things stand," says Kui Liu. 

Kui Liu's group demonstrated in the study that a short treatment with the PTEN inhibitor can trigger the growth of small eggs, and that this treatment makes it possible to produce plenty of mature eggs. 

The results also show that healthy, live young can be born from treated eggs used in IVF. Not only were the young mice born fertile, they also showed no signs or symptoms of chronic disease at the age of 15 months, which equates to 70 human years. 

Kui Liu is a professor of molecular biology and his group specialises in the study of molecular mechanisms that affect the development of female reproductive cells. His aim is to be able to use this method to help women. 

"We hope to see this method being used clinically within five to ten years," says Kui Liu. 

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New Study Reaffirms That Breast Cancer Screening Saves Lives

Dr. Enrique Jacome

The study, published in Cancer Epidemiology, Biomarkers and Prevention is the largest of its kind in Australia and one of the largest in the world. It followed about 4,000 women in a study of the BreastScreen program in Western Australia. 

University of Melbourne Research Fellow Dr Carolyn Nickson and colleagues from the Melbourne School of Population Health said the findings reaffirmed the importance and efficacy of mammography. 

The study focused on women aged 50-69 years, who are in the target age range for screening. It included 427 cases where women had died from breast cancer and 3,650 control women who were still alive when the other women died. 

The research team compared screening attendance between the two groups and found screening was much lower among women who had died from breast cancer, a finding that is consistent with a similar study from South Australia and with numerous studies from around the world. Comparison with similar studies showed an average estimate of a 49% reduced risk of dying. 

Some other studies including studies from Australia claim that screening doesn't reduce risk of dying from breast cancer. However, these studies do not compare outcomes for individual women. 

"Sound research methods have been used in this study. I believe it is time to move on from the debate about whether screening reduces mortality and to instead direct research resources to help improve the program for women who choose to use it," Dr Nickson said. 

"It is important that Australian women have accurate information about the pros and cons of participating in BreastScreen. The findings of this study may help women decide whether to participate." 

"Early detection is the key to early treatment and the free BreastScreen program is the best health service available to detect breast cancers earlier in women aged 50-69 years."

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Study Shows That Post-Menopausal Women Have Difficulty With Long-Term Weight Loss

Dr. Enrique Jacome

Postmenopausal women naturally consume much less energy than when they were younger, the strategies and behaviors they followed earlier in life are simply not sustainable or effective in the long-term any more, researchers from the University of Pittsburgh Department of Health and Physical Activity, reported in the Journal of the Academy of Nutrition and Dietetics. The authors added that several factors work against postmenopausal women when they try to lose weight over the long term.

Several studies have looked at postmenopausal body weight control and diets. A team of researchers from the University of Illinois said that postmenopausal dieting women should eat plenty of protein so that they do not lose too much muscle. Another study warned thathigh-protein diets may encourage bone density loss in postmenopausal women.

Even for younger females and men of all ages, dropping the pounds initially during a diet is usually achievable, but keeping the weight off over the long term is challenging. For postmenopausal women, the authors say, it is much harder.

Postmenopausal women are at a higher risk of developing certain diseases and conditions - those who are overweight have an even higher risk. Overweight postmenopausal women who manage to lose weight, have much better health outcomes. A study carried out by researchers from the Prevention Center at the Fred Hutchinson Cancer Research Center in Seattle, Washington, found that those who lost at least 5% of their bodyweight had noticeable reductions in markers of inflammation.

The researchers found that behaviors which are linked to weight loss initially during a diet and exercise drive, just simply do not work after a while for post-menopausal females. They believe that interventions which target these behaviors could help older women achieve positive long-term outcomes, especially obese women.

Lead researcher Bethany Barone Gibbs, PhD, explained that several factors make weight loss much harder for post-menopausal women:

"Not only does motivation decrease after you start losing weight, there are physiological changes, including a decreased resting metabolic rate. Appetite-related hormones increase. Researchers studying the brain are now finding that you have enhanced rewards and increased motivation to eat when you've lost weight."

If you add them all up, greater appetite, a lower resting metabolic rate, etc., it is very difficult for post-menopausal women to lose weight and to keep it off.

Traditionally, treatments, particularly behavioral ones for obesity, have over-concentrated on keeping the calories down - an approach which may sound good in theory, but has very disappointing long-term results. Dr. Gibbs and team set out to find out what impact certain alterations in eating behaviors and selected foods might have on weight loss after six and 48 months. They focused just on post-menopausal women who were overweight.

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Study Shows Working Moms Enjoy Better Physical & Mental Health

Dr. Enrique Jacome

Moms who work full-time are healthier at age 40 than moms who stay at home, work part time, or moms who find themselves repeatedly out of work. This was the result of a study reported on Monday, the last day of the Annual Meeting of the American Sociological Association in Denver, Colorado.

Co-author Adrianne Frech, Assistant Sociology Professor at the University of Akron in Ohio, told the press, work is good for both physical and mental health, for many reasons: "It gives women a sense of purpose, self-efficacy, control and autonomy." "They have a place where they are an expert on something, and they're paid a wage," she added.

However, Frech and co-author Sarah Damaske of Pennsylvania State University, said rather than stir up the going-out-to-work versus stay-at-home debate, their research highlights a recently identified group, whom they label the persistently unemployed.

 
They say this group of mothers deserves more attention because they appear to be the least healthy at around age 40. Persistently unemployed mothers are in and out of the workforce, often not by their own choice. They repeatedly experience the highs and lows of finding rewarding work, only to lose it and have to start all over again. This becomes a health risk because of the stress caused by work instability.

"Struggling to hold onto a job or being in constant job search mode wears on their health, especially mentally, but also physically," said Frech. "Women with interrupted employment face more job-related barriers than other women, or cumulative disadvantages over time," she added.

For their study, Frech and Damaske analyzed longitudinal data on 2,540 women who became mothers between 1978 and 1995. After adjusting for other factors that could influence the findings, such as prior health, employment before pregnancy, race/ethnicity, single motherhood, cognitive ability, and age at first birth, they found the choices women make early in their professional lives can influence their health later on.

Women who go back to full time work shortly after having children reported better health, both physical and mental. They have more mobility, less tendency to depression, and have more energy, at age 40.

Frech and Damaske suggest if women are able to make good choices before they have their first child, they are more likely to enjoy better health later on. "Examples of good choices could be delaying your first birth until you're married and done with your education, or not waiting a long time before returning to the workforce," said Frech.

Frech suggests working full time brings many benefits that part time workers rarely see: not only is the pay higher, but the chances of promotion are better, there is more job security and more fringe benefits. In contrast, mothers who stay at home may find themselves socially isolated and financially dependent.

Work makes you healthier and gives you the opportunity to save a nest egg, says Frech. "Also, should a divorce happen, it is harder to enter the workforce if you don't have a solid work history. Don't give up on work and education," she adds.

Frech also suggests society benefits when single mothers are offered child care and transportation, because this results in better job prospects for them.

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Study Shows Exercise Can Protect Premenopausal Women's Bones

Dr. Enrique Jacome

According to new research, premenopausal women who engage in physical activity can significantly reduce a known inhibitor of bone formation called sclerostin. 

The study, which will be published in the October issue of Endocrine Society'sJournal of Clinical Endocrinology and Metabolism (JCEM), also found that physical activity improved IGF-1 levels, which have a positive impact on bone formation.

Sclerostin is a glycoprotein produced primarily by osteocytes, the most abundant cells found in the human bone. Once released, sclerostin migrates to the bone surface where it triggers the production of cells that help bones develop.

Mohammed-Salleh M. Ardawi, Ph.D., FRCPath, professor at the Center of Excellence for Osteoporosis Research and Faculty of Medicine at King Abdulaziz University in Saudi Arabia, explained: 

"Physical activity is good for bone health and results in lowering sclerostin, a known inhibitor of bone formation and enhancing IGF-1 levels, a positive effector on bone health. We also found physical activity training that enhances mechanical loading in combination with anabolic therapeutic agents will had added positive effect on bone health, particularly bone formation."

The team examined 1,235 premenopausal women for the study. They followed 58 women during an 8-week course of physical activity training and compared them with 62 women who acted as controls.

All study participants underwent a medical examination and had their measurements taken for bone mineral density, bone turnover markers, serum sclerostin and IGF-1.

The team found that women who engaged in 2+ hours of physical activity per week had considerably lower levels of serum sclerostin than those who had less than 2 hours of physical activity per week. However, those who regularly exercised had higher IGF-1 levels.

Ardawi said:

"Physical activity training is conceptually simple, inexpensive, and can serve practical purposes including reducing the risk of low bone mass, osteoporosis, and consequently fractures. Our study found that even minor changes in physical activity were associated with clear effects on serum levels of sclerostin, IGF-1 and bone turnover markers."

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Hospital Creates Guidelines To Help Identify Mothers At Risk Of Postpartum Depression

Dr. Enrique Jacome

Although 13 percent of new mothers experience postpartum depression (PPD) in the first year after childbirth, few women recognize the symptoms and seldom discuss their feelings with a health care provider. University of Louisville Hospital (ULH) hopes to change this statistic through a new policy to guide hospital-based perinatal nurses in caring for women with risk of PPD. 

M. Cynthia Logsdon, PhD, APRN, FAAN, professor, University of Louisville School of Nursing, and associate chief of nursing research, University of Louisville Hospital and the James Graham Brown Cancer Center, and her team created evidence-based practice guidelines using research recently published on-line in The American Journal of Maternal Child Nursing. 

"The hospital policies and procedures are designed to provide perinatal nurses the tools they need to prepare new mothers so they are able to self-monitor for symptoms of depression and know what steps to take if they experience symptoms," Logsdon said. 

According to Logsdon, most hospitals lack comprehensive perinatal patient PPD assessment, education and referral policies. Although professional organizations such as the Registered Nurses' Association of Ontario previously published a best practices guideline, the recommendations did not focus on the first few days following childbirth or nursing care while the new mother was hospitalized. 

"Our recommendations for nursing practice of hospital-based perinatal nurses go beyond previous published guidelines," Logsdon said. 

Logsdon and her team, Diane Eckert, BSN, RN, clinical manager, mother-baby unit, ULH, and Roselyn Tomasulo, RN, MSN, perinatal educator, collaborated with internationally-known researchers in the field to draft the article, Identification of Mothers at Risk for Postpartum Depression by Hospital Based Perinatal Nurses. A task force of clinical nurses was consulted to determine how to improve nursing practice at ULH. Implementation included identifying at-risk patients and referral sources; physician and staff education was another component. 

"When many nurses enter the profession, they don't fully understand their critical role as patient educators," Tomasulo said. "We are helping our perinatal nurses feel more competent in their roles by offering inter-hospital on-line education and staff training." 

During the obstetric patient admission process, ULH perinatal nurses now assess new mothers for PPD and suicide risk factors: low-income status, lack of social support and previous history of depression. If a patient is at risk, it is reported to the obstetrical physician. The evening before hospital discharge, all new mothers fill out a questionnaire that utilizes the Edinburgh Postnatal Depression Scale (EPDS). Mothers are asked questions such as whether they feel anxious or worried for no particular reason and whether they feel sad or miserable. The higher the score, the greater the risk for PPD. 

The physician, social services worker and oncoming shift nurse are then informed. The nurse who administered the EPDS reviews the results of the depression screening with the patient and her support person. Patients also are informed about depression symptoms and what to do if they begin to feel hopeless. 

New mothers go home with a list of community resources and physician referrals, so names and numbers are at their finger-tips in case they need to seek help. They're asked to retake the EPDS questionnaire about a week later after leaving the hospital to see if they're experiencing PPD symptoms. 
"We hope our work will be seen as a model of good policy and can be considered by other hospitals and professional organizations," Logsdon said. 

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Women Who Give Birth After Age 30 Have A Lower Risk Of Endometrial Cancer

Dr. Enrique Jacome

Women who last give birth at age 40 or older have a 44 percent decreased risk of endometrial cancer when compared to women who have their last birth under the age of 25, according to strong evidence in a new, international study led by a researcher at the Keck School of Medicine of USC. 
Endometrial cancer strikes the endometrium, the tissue lining the uterus (womb), and is the most common gynecological cancer in the United States. 

Veronica "Wendy" Setiawan, Ph.D., assistant professor of preventive medicine at the Keck School, was the principal investigator of the study, "Age at Last Birth in Relation to Risk of Endometrial Cancer: Pooled Analysis in the Epidemiology of Endometrial Cancer Consortium," which found that risk begins to decrease after age 30 by approximately 13 percentage points for each five-year delay in last births. Compared to women who last give birth before age 25, those who have their last child between age 30 and 34 reduce their risk by 17 percent and those between age 35 and 39 reduce their risk by 32 percent. 

"While childbearing at an older age previously has been associated with a lower risk of endometrial cancer, the size of this study definitively shows that late age at last birth is a significant protective factor after taking into account other factors known to influence the disease - body weight, number of kids and oral contraceptive use," Setiawan said. 

The study, believed to be the largest of its kind, examined pooled data from four cohort studies and 13 case-control studies. Funded by the National Cancer Institute, the research examined a total of 8,671 cases of endometrial cancer and 16,562 control subjects, all derived from studies in the Epidemiology of Endometrial Cancer Consortium. Results are now available online in theAmerican Journal of Epidemiology. 

"We found that the lower risk of endometrial cancer continued for older mothers across different age-at-diagnosis groups, including under 50, 50-59, 60-69, and over 70 - which shows that the protection persists for many years," Setiawan said. "Protection also did not vary by the two types of the disease: the more common Type 1, which we think is related to estrogen exposure; and the more rare, but more aggressive and deadly, Type 2, which have been thought to develop independent of hormones." 

Setiawan noted that endometrial cancer is the fourth most common cancer diagnosed among American women. The American Cancer Society estimates that in 2012 about 47,130 new cases of cancer of the uterine body will be diagnosed, and about 8,010 women will die from such cancers. The vast majority of those cases are endometrial cancer. 

Setiawan's research also examined whether the association between age at last birth and endometrial cancer was consistent across race and ethnicity. The protective association was observed in Caucasian and Asian women, but not in the study's small subset of black women, and Setiawan suggested this warrants additional study of larger groups of black women. 

More research is necessary to determine why late age at last birth might protect against endometrial cancer, but Setiawan notes that several potential mechanisms have been suggested by other investigators, including:

• Women capable of becoming pregnant at an older age may possess a healthy endometrium or experience fewer menstrual cycles without ovulation;
• Prolonged exposure to the hormone progesterone during pregnancy may be especially beneficial at older ages, the critical period for endometrial cancer development;
• Premalignant or malignant cells of the uterine cavity's mucosal lining, which are more likely to exist with increasing age, are shed during childbirth.

"This study shows an important protective factor for endometrial cancer, and when the exact mechanism by which it protects women from getting the disease is known, it can help our understanding of how endometrial cancer develops and thus how to prevent it," Setiawan said. 

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